Incidental detection of Chilaiditi sign in an asymptomatic 28-year-old woman during routine pre-travel screening

Chilaiditi sign is an uncommon radiographic finding characterized by interposition of the bowel between the liver and diaphragm and is often identified incidentally in asymptomatic individuals. Its clinical significance lies in its potential to mimic serious intra-abdominal conditions, leading to unnecessary diagnostic or surgical interventions if misinterpreted. We report the case of a 28-year-old woman undergoing routine pre-travel screening in whom Chilaiditi sign was incidentally detected on posteroanterior chest radiography. The patient was asymptomatic, with unremarkable physical examination and normal laboratory findings. Imaging demonstrated a gas-filled colonic loop with visible haustral markings beneath the right hemidiaphragm, without evidence of free intraperitoneal air. Given the absence of symptoms and the presence of characteristic imaging features, no further investigations or interventions were required. This case highlights the importance of recognizing this benign entity and correlating radiologic findings with clinical presentation to avoid unnecessary procedures.